NPIMap

Individual provider Active NPI

Fedor E Panov, M.D.

  • Neurological Surgery Physician
  • New York, NY
National Provider Identifier
1962661686
Registry record updated Jun 6, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurological Surgery PhysicianTaxonomy code 207T00000X
License
AM970780539892 Issued in NY
Practice address
1249 Park Ave Apt 10G
New York, NY 10029-7220
Phone
(570) 578-6634
NPI assigned
Jun 6, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 6, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurological Surgery Physician 207T00000X AM970780539892 NY Primary

Addresses

Primary practice location

1249 Park Ave Apt 10G
New York, NY 10029-7220

Mailing address

1249 Park Ave Apt 10G
New York, NY 10029-7220
Phone (570) 578-6634

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151001001886 NY Practitioner - Neurosurgery 2668780206 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Neurosurgery
Education
Jefferson Medical College of Thomas Jefferson University, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

1 Gustave Levy Place
Mount Sinai Hospital
New York, NY 10029-6500
Phone (212) 731-6761

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Spinal fusion1-10
Laminectomy or laminotomy (partial removal of spine bones)14
Melanoma (skin cancer) excision1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
AM970780539892NYMDNeurological Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Icahn School of Medicine at Mount Sinai CurrentSince Sep 16, 2021 Accepting new patients
Icahn School of Medicine at Mount Sinai CurrentSince Sep 16, 2021 Accepting new patients
Icahn School of Medicine at Mount Sinai Current Accepting new patients
Icahn School of Medicine at Mount Sinai Neurological Surgery CurrentSince Jul 1, 2015 Accepting new patients
Icahn School of Medicine at Mount Sinai CurrentSince Jul 1, 2015 Accepting new patients
St Lukes Roosevelt Hospital Center Past Accepting new patients

Locations

7901 Broadway
Rm A119
Elmhurst, NY 11373
Phone (718) 334-3915

150 E 42nd St
#10
New York, NY 10017

1000 10th Ave
Ste 10C
New York, NY 10019
Phone (212) 523-3452

1010 N Broadway
Yonkers, NY 10701
Phone (914) 968-3535

Networks

  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H1722

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 10

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1212710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1212710400000",
    "number": "1962661686",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1249 PARK AVE APT 10G",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100297220",
            "telephone_number": "570-578-6634"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1249 PARK AVE APT 10G",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100297220",
            "telephone_number": "570-578-6634"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PANOV",
        "first_name": "FEDOR",
        "middle_name": "E",
        "name_prefix": "Mr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-06-06",
        "last_updated": "2008-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "NY",
            "license": "AM970780539892",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.